Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2013.09.010
Brazilian Journal of Anesthesiology
Scientific Article

Administration of paracetamol versus dipyrone by intravenous patient-controlled analgesia for postoperative pain relief in children after tonsillectomy

Administração de paracetamol versus dipirona em analgesia controlada pelo paciente por via intravenosa para alívio da dor no pós-operatório de crianças após tonsilectomia

Mesut Sener; Aysu Kocum; Esra Caliskan; Ismail Yilmaz; Fatma Caylakli; Anis Aribogan

http://dx.doi.org/10.1016/j.bjane.2013.09.010 Braz J Anesthesiol, vol.65, n6, p.476-482, 2015
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Abstract

BACKGROUND AND OBJECTIVE: We compared the efficacy of intravenous (IV) paracetamol versus dipyrone via patient-controlled analgesia (PCA) for postoperative pain relief in children. METHODS: The study was composed of 120 children who had undergone elective tonsillectomy after receiving general anesthesia. Patients were divided into 3 groups according to the dosage of postoperative intravenous-patient-controlled analgesia: paracetamol, dipyrone, or placebo. Pain was evaluated using a 0- to 100-mm visual analog scale and 1- to 4-pain relief score at 30 min, 1, 2, 4, 6, 12, and 24 h postoperatively. Pethidine (0.25 mg kg-1) was administered intravenously to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24 h postoperatively, and treatment related adverse effects were noted. RESULTS: Postoperative visual analog scale scores were significantly lower with paracetamol group compared with placebo group at 6 h (p < 0.05), dipyrone group compared with placebo group at 30 min and 6 h (p < 0.05). No significant differences regarding visual analog scale values at 1, 2, 4, 12, and 24 h were found. No significant differences were found between groups with respect to pain relief score (p > 0.05). Postoperative pethidine requirements were significantly lower with paracetamol and dipyrone groups compared with placebo group (62.5%, 68.4% vs 90%, p < 0.05). No significant differences were found between groups with respect to nausea, vomiting and the any other adverse effects of the drugs (p > 0.05). CONCLUSIONS: Paracetamol and dipyrone have well tolerability profile and effective analgesic properties when administered IV-PCA for postoperative analgesia in children after tonsillectomy.

Keywords

Analgesia, Patient-controlled, Pediatric, Pain, Postoperative, Tonsillectomy

Resumo

JUSTIFICATIVA E OBJETIVO: Comparamos a eficácia da administração de paracetamol versus dipirona em analgesia controlada pelo paciente (PCA) por via intravenosa (IV) para alívio da dor no período pós-operatório em crianças. MÉTODOS: O estudo foi composto por 120 crianças submetidas à tonsilectomia sob anestesia geral. Os pacientes foram divididos em três grupos de acordo com a dose IV de analgesia controlada pelo paciente no pós-operatório: paracetamol, dipirona ou placebo. A dor foi avaliada com uma escala visual analógica de 0-100 mm e escore de 1-4 para alívio da dor nos tempos de 30 minutos, uma, duas, quatro, seis, 12 e 24 horas de pós-operatório. Petidina (0,25 mg kg-1) foi administrada IV aos pacientes que precisaram de analgesia de resgate. A necessidade de petidina foi registrada durante as primeiras 24 horas de pós-operatório e os efeitos adversos relacionados ao tratamento foram registrados. RESULTADOS: Os escores da escala visual analógica no pós-operatório foram significativamente menores no grupo paracetamol em comparação com o grupo placebo em seis horas (p < 0,05) e no grupo dipirona em comparação com o grupo placebo em 30 minutos e seis horas (p < 0,05). Não houve diferença significativa em relação aos valores da escala visual analógica nos tempos avaliados de uma, duas, quatro, 12 e 24 horas. Não houve diferença significativa entre os grupos quanto ao escore de alívio da dor (p > 0,05). A necessidade de petidina foi significativamente menor nos grupos paracetamol e dipirona em comparação com o grupo placebo (62,5%, 68,4% vs. 90%, p < 0,05). Não houve diferença significativa entre os grupos em relação à incidência de náusea, vômito e outros efeitos adversos dos medicamentos (p > 0,05). CONCLUSÕES: Paracetamol e dipirona têm um perfil de boa tolerabilidade e propriedades analgésicas eficazes quando administrados IV para ACP no pós-operatório de crianças após tonsilectomia.

Palavras-chave

Analgesia, Controlada pelo paciente, Pediatria, Dor, Pós-operatório, Tonsilectomia

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